It is now nearly three decades since the first clinical description of the syndrome of inappropriate antidiuretic hormone secretion (SIADH).1 Within this relatively short period of time, SIADH has become recognized as the most prevalent cause of significant hyponatremia encountered in clinical practice.2 Tumors remain the most common cause of nondrug induced SIADH, and the list of tumors associated with hyponatremia has gradually expanded to include a variety of neoplasms other than the most frequently implicated small cell carcinoma of the lung.3 In this issue of the Archives, yet another tumor producing hyponatremia, an olfactory neuroblastoma, is reported.4 This case is of interest not because of the few times that we as clinicians will diagnose this rare tumor, but because it serves to focus attention on several important issues in this area, some of which represent still unresolved questions.
First, it should be remembered that not
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